Aminoindanes--the next wave of 'legal highs'?

Due to its closed ring system, 2-aminoindane is a conformationally rigid analogue of amphetamine. Internet websites offering synthetic compounds as 'research chemicals' have recently been advertising 5,6-methylenedioxy-2-aminoindane (MDAI), 5, 6-methylenedioxy-N-methyl-2-aminoindane (MDMAI), 5-iodo-2-aminoindane (5-IAI), and 5-methoxy-6-methyl-2-aminoindane (MMAI). The chemistry, pharmacology, and toxicological aspects of this new class of psychoactive substances are reviewed, as these could become the next wave of 'legal highs'.

Fluoromethcathinone, a new substance of abuse.

We have identified a new compound in capsules marketed as plant feeders available from internet suppliers. It is apparent from internet forums that these so-called plant feeders are being used as recreational drugs. The material is identified as being 3'-fluoromethcathinone. The compound in the capsule was identified by GC-MS, 1H, (13)C and (19)F NMR as well as FTIR. Other materials identified in the tablet were caffeine and a methylamine salt. The exact position of the fluorine in the fluoromethcathinone was determined by comparison with materials synthesised in our laboratory. Internet-based companies are known to sell 4'-fluoromethcathinone (flephedrone). We present GC-MS data for the three isomers of fluoromethcathinone and their N-acetyl derivatives and provide a rapid method for determining the positional isomers of fluoromethcathinone using FTIR or (19)F NMR.

The effects of MMPI-A T-score elevation on classification accuracy for normal and clinical adolescent samples.

In this investigation we examined the ability of the Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) to classify accurately both clinical and normal adolescents using 2 different T-score elevation ranges, T > or = 60 and T > or = 65, and using 2 different clinical base rates for the occurrence of psychopathology. A clinical base rate of 50% and 20%, respectively, were created by comparing a clinical sample of 203 adolescent inpatients with cooccurring substance abuse and psychiatric disorders with 2 subsamples from the MMPI-A normative group. These subsamples consisted of 203 adolescents matched for sex and age, and a larger subsample of 1,015 adolescents proportionately matched for sex and age, with the clinical group. Classification accuracy analyses revealed that although clinical base rate did affect the accurate classification of cases, a T-score cutoff of 65 resulted in higher levels of accurate classification overall while minimizing the misclassification of both clinical and normal cases. Implications of these findings for the recommended use of the MMPI-A "gray zone" are presented, and the relative areas of strength and weakness of the MMPI-A are reviewed in the identification and description of psychopathology.

An evaluation of the usefulness of the MMPI-2 F(p) scale.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) F(p) scale was developed by Arbisi and Ben-Porath (1995) by identification of 27 items endorsed by fewer than 20% of individuals in both normal and psychiatric samples. The F(p) scale was designed for applications in settings characterized by high base rates of serious psychopathology, such as psychiatric inpatient units, and is proposed as a useful scale in discriminating overreported protocols from those produced by patients with serious psychopathology. In this study we investigated the characteristics of this scale in a sample of 617 psychiatric inpatients who responded to the MMPI-2 under standard conditions, and 203 overreported protocols derived in research studies conducted with normal adult participants instructed to simulate various forms of serious psychopathology. Results of this study are consistent with prior reports of a relatively low frequency of item endorsement for F(p) scale items in psychiatric samples, and intercorrelations between the F(p) scale and the MMPI-2 basic clinical scales in clinical samples that are generally lower than those produced between either F or Fb and the basic clinical scales. However, this intercorrelational pattern between F(p) and the MMPI-2 basic scales was not as consistent for the overreported sample. Additionally, the F(p) scale appears to be effective in discriminating overreported from accurate MMPI-2 protocols, with some evidence that the optimal cutting scores for this and other MMPI-2 infrequency scales may differ as a function of gender. Finally, these findings do not show clear evidence of improved group prediction derived from the use of the F(p) scale in contrast to results obtainable through the use of the MMPI-2 F scale.

An evaluation of the effects of Rorschach EB style on the diagnostic utility of the Depression Index.

Several empirical studies have found the Rorschach Depression Index (DEPI) to have questionable diagnostic utility. Studies using adolescent samples suggest that the DEPI has limited sensitivity and fails to differentiate effectively between adolescents with and without depression diagnoses. The present study was conducted to evaluate Viglione, Brager, and Haller's suggestion that the DEPI may have better discriminative ability for individuals with extratensive problem-solving styles, measured by the Rorschach EB (Erlebnistypus) variable, compared to those with introversive and ambitent styles. Comparisons were conducted between adolescents with depression-related diagnoses and adolescents with other diagnoses for each of the three EB groups. The results failed to support the hypothesized greater discriminative power of DEPI for depressed extratensives, and suggest caution in using the DEPI to evaluate adolescent depression.

Evaluation of an MMPI--a short form: implications for adaptive testing.

Efforts to develop a viable short form of the MMPI (Hathaway & McKinley, 1943) span more than 50 years, with more recent attempts to significantly shorten the item pool focused on the use of adaptive computerized test administration. In this article, we report some psychometric properties of an MMPI-Adolescent version (MMPI-A; Butcher et al., 1992) short form based on administration of the first 150 items of this test instrument. We report results for both the MMPI-A normative sample of 1,620 adolescents and a clinical sample of 565 adolescents in a variety of treatment settings. We summarize results for the MMPI-A basic scales in terms of Pearson product-moment correlations generated between full administration and short-form administration formats and mean Tscore elevations for the basic scales generated by each approach. In this investigation, we also examined single-scale and 2-point congruences found for the MMPI-A basic clinical scales as derived from standard and short-form administrations. We present the relative strengths and weaknesses of the MMPI-A short form and discuss the findings in terms of implications for attempts to shorten the item pool through the use of computerized adaptive assessment approaches.

The effectiveness of MMPI-A items in discriminating between normative and clinical samples.

The Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992) was released in 1992 and has rapidly become the most widely used objective personality assessment instrument with adolescents. Although the MMPI-A reduced or eliminated several problems associated with the use of the original MMPI (Hathaway & McKinley, 1943) with adolescents, the MMPI-A does produce a high frequency of within normal limits basic scale profiles for individuals with substantial psychopathology including adolescents in inpatient psychiatric settings. To better understand the reasons for this phenomenon, we compared the item endorsement frequencies for the MMPI-A normative sample with results from two adolescent clinical samples, and these results were contrasted to the item endorsement frequencies for the MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) normative sample and a clinical sample of adult psychiatric inpatients. Results showed that the MMPI-A contains a substantial number of items that do not show a significant difference in item endorsement frequency between normative and clinical samples. Furthermore, MMPI-A basic and content scales generally show a much lower percentage of effective items than do the corresponding scales for the MMPI-2. We discuss the findings in relation to the frequent occurrence of low range MMPI-A profiles in clinical samples and the potential usefulness of these results in future efforts to develop viable short forms for the MMPI-A.

The hard science of Rorschach research: what do we know and where do we go?

As the final article in the Special Series on "The Utility of the Rorschach for Clinical Assessment," the authors provide an overview of this instrument's current status. They begin with a thorough review of global and focused meta-analyses, including an expanded analysis of K. C. H. Parker, R. K. Hanson, and J. Hunsley's (1988) data set, and conclude that Rorschach, Minnesota Multiphasic Personality Inventory, and IQ scales each produce roughly similar effect size magnitudes, although all tests have greater validity for some purposes than for others. Because this evidentiary foundation justifies addressing other issues, the authors build on contributions to the Special Series to identify 11 salient theoretical and empirical gaps in the Rorschach knowledge base and make recommendations for addressing these challenges to further the evolution of the Rorschach and document its strengths and inherent limitations.

Psychological test usage with adolescent clients: survey update.

In 1991, Archer, Maruish, Imhof, and Piotrowski presented survey findings based on the responses of a national sample of psychologists who performed psychological assessment with adolescent clients. The current survey was designed to update their results by examining the test use practices reported by 346 psychologists who work with adolescents in a variety of clinical and academic settings. These respondents represented an adjusted survey return rate of 36% and predominantly consisted of doctoral prepared psychologists (95%) in private practice settings (51%). The survey respondents had a mean of 13.6 years of post-degree clinical experience, and spent an average of 45% of their clinical time working with adolescents. Survey results reveal a substantial similarity in test usage between the 1991 survey and the current investigation. For example, the Wechsler Intelligence Scales, Rorschach, Thematic Apperception Test (TAT), and Minnesota Multiphasic Personality Inventory (MMPI) remain among the widely used tests with adolescents. However, several changes were also noted including a reduction in the use of the Bender-Gestalt and increases in the use of parent and teacher rating instruments. The current findings are used to estimate the relative popularity of an extensive list of test instruments, compare current findings to 1991 survey results, and to examine several issues related to general effects of managed care procedures and policies on test usage with adolescents.

A shortened version of the MMPI-2.

A psychometrically sound method of prorating scores from a shortened version of the MMPI-2 is presented to approximate the full-scale raw scores on the basic scales. After a brief review of the history of short versions of the original MMPI and their strengths and weaknesses, justifications for developing and publishing this new version are offered. In spite of the risk of abuse by harassed and over-worked clinicians, there are cogent reasons to make this set of procedures available to practitioners and research investigators. These procedures were devised on the data from the 2,600 men and women in the original MMPI-2 restandardization sample and cross-validated on a sample of 632 test records from a psychiatric inpatient service. The dependability of estimated single raw scores as well as of the patterning of the prorated profile patterns is explored.

MMPI-A patterns related to the endorsement of suicidal ideation.

This study focused on the relationship between the occurrence of specific Minnesota Multiphasic Personality Inventory Adolescent (MMPI-A) basic scale profile patterns and the frequency of endorsement of three items related, in varying degrees, to suicide ideation (MMPI-A Items 177, 283, and 399). The research sample consisted of adolescents (n = 348) with diagnoses of depression, conduct disorder, and other psychiatric disorders. Significant relationships were found for the overall MMPI-A basic scale profile, several MMPI-A single scale high points, and specific two-point codetype groupings. Findings revealed higher basic clinical scale profiles for those adolescents endorsing suicidal ideation. Further results revealed lower frequencies of item endorsement for spike 4 and spike 9 profiles, and higher item endorsement frequencies for Scale 2, Scale 8, and for the two-point codetypes of 4-8/8-4, 8-9/9-8 and 6-8/8-6. Issues are discussed related to the clinical usefulness and limitations of the MMPI-A in the assessment and prediction of suicidal ideation and behavior in adolescents.

Identification of random responding on the MMPI-A.

Although substantial research literature on the effects of random responding on the MMPI-2 exists, there is very limited data available on this issue with the MMPI-A. The purpose of this study was to evaluate the utility of selected MMPI-A validity scales in detecting differences in response patterns between protocols produced by 354 adolescents assessed in clinical settings and a group of 354 randomly produced MMPI-A protocols. Results indicate that MMPI-A validity and basic clinical scales differ significantly between random and clinical groups and that MMPI-A validity Scales F, F1, F2, and VRIN appear to be most useful in correctly identifying protocols from actual clinical participants versus randomly generated response patterns. Findings are discussed in terms of the dramatic effects of the sample base rate for random responding on overall classification accuracy results. Furthermore, it was noted that the optimal cutting scores for MMPI-A Scales F, F1, F2, and VRIN were largely consistent with interpretive recommendations found in the test manual (Butcher et al., 1992) when the relative frequency of random response protocols to clinical protocols was evaluated at a ratio of 1:10. Finally, future recommendations for evaluation of the F1-F2 difference score and the TRIN scale are offered in terms of the most relevant research designs to evaluate these measures.

A comparison of two interpretive approaches for the MMPI--A Structural Summary.

We undertook this study to provide empirically derived interpretative recommendations for the MMPI-A Structural Summary through an evaluation of factor elevation patterns. We examined the frequency of single-factor, two-factor, and multifactor elevations in a clinical sample of 363 adolescents receiving inpatient, outpatient, or residential treatment. Two methods of determining factor elevation (a simple majority of scales and subscales within a specific factor with T-score elevations at critical level, versus the mean T score generated by all the scales and subscales for each factor) yielded comparable findings concerning the frequency of factor elevation, permitting reliance on the former, easier-to-use method to define elevation. The most salient two-factor co-elevations were the 3-7 (Disinhibition-Familial Alienation), 2-8 (Immaturity-Psychoticism), 1-5 (General Maladjustment-Health Concerns), and 2-7 (Immaturity-Familial Alienation) patterns. This study also examined whether factor pattern elevations varied as a function of age, gender, or diagnosis. Data analyses revealed no differences between younger (ages 13-14) and older (ages 15-18) adolescents on factor elevation as defined by the first criterion. However, significant differences were found between boys and girls on Factors 3 (Disinhibition) and 5 (Health Concerns). Results also indicated that a larger proportion of depressed adolescents obtained factor elevations on Factors 4 (Social Discomfort) and 5 (Health Concerns) compared to adolescents with conduct disorder diagnoses and other diagnoses. The findings of this study are discussed with reference to recommended procedures for using the Structural Summary in clinical assessment practice.

Effects of two MMPI-2 validity scales on basic scale relations to external criteria.

Many clinicians have come to rely on the broad array of validity scales available on the MMPI and the MMPI-2. In this study, we evaluated the utility of 2 MMPI-2 validity scales, the K scale and VRIN scale, in a sample of 692 psychiatric inpatients. Specifically, the effects of the K-correction procedure and the exclusion of protocols based on VRIN scale elevations were examined on the relation between MMPI-2 basic clinical scales and external criteria including both self-report and clinician ratings of psychopathology. Results indicated that the K-correction procedure commonly used with the MMPI and MMPI-2 did not result in higher correlations with external criteria in comparison to non-K-corrected scores. In contrast, MMPI-2 protocols that produced VRIN T-score values > or = 80 generally produced lower correlations with patients self-reports and clinician ratings of psychopathology in comparison to protocols judged to be valid based on VRIN scale results.

Future directions for the MMPI-A: research and clinical issues.

The Minnesota Multiphasic Personality Inventory-Adolescent (MMPI-A; Butcher et al., 1992), released in 1992, was developed specifically for use with adolescent respondents. The purpose of this article is to offer suggestions concerning 6 areas of productive research with this instrument. These areas include studies of the utility of codetype interpretation, issues related to profile elevation in clinical samples, and the identification of criterion for evaluating the usefulness of traditional and new MMPI-A scales. Further, these research issues also include establishing the optimal age ranges for use with the MMPI-A, detecting the effects of the release of a revised instrument on clinician's test use patterns with adolescents, and evaluating the optimal methods for the use of the MMPI-A Structural Summary interpretative approach. It is noted that these research recommendations are by no means exhaustive, and that many other research areas should also be investigated in developing a comprehensive research literature for this revised instrument.

MMPI-A and Rorschach indices related to depression and conduct disorder: an evaluation of the incremental validity hypothesis.

This investigation extends the earlier research by Archer and Gordon (1988) by examining the extent to which combining indices from the newly released MMPI-A and the revised Rorschach Comprehensive System furnishes incremental validity in terms of improved diagnostic prediction. The predictive accuracy of selected MMPI-A and Rorschach variables conceptually related to diagnoses of depression and conduct disorder were compared in a clinical sample of 152 adolescents. Results of multivariate analyses of variance revealed some significant differences between diagnostic groups on several MMPI-A scales, and 1 significant difference on the Rorschach involving the Vista variable. Stepwise discriminant function analyses resulted in 2 MMPI-A scales and 2 Rorschach variables that collectively accounted for a small proportion of variance in the diagnosis of depression, and 3 MMPI-A scales that accounted for a significant component of variance in the conduct disorder diagnosis. Classification accuracy results indicated that the hit rate for depression diagnosis did not improve using an optimal linear combination of the 4 variables over the rates produced by the single use of either the MMPI-A Depression content scale (A-DEP) or Scale 2. For the conduct disorder diagnosis, the optimal linear combination of MMPI-A Conduct Problems (A-CON), Cynicism (A-CYN), and Immaturity (IMM) scales served as the best predictor, and no Rorschach variables contributed significantly to classification accuracy. Our results replicated the findings of Archer and Gordon (1988) in indicating that the combined use of MMPI-A and Rorschach variables does not appear to produce incremental increases in accuracy of diagnostic classification.

MMPI and Rorschach Characteristics of Individuals Approved for Gender Reassignment Surgery.

Results of past empirical studies utilizing the Minnesota Multiphasic Personality Inventory (MMPI) and the Rorschach Inkblot Test (Rorschach) have tended to be equivocal regarding the level and nature of psychopathology associated with samples of individuals requesting gender reassignment surgery. The present study compared the MMPI-2 basic scale T scores from a gender reassignment applicant sample (56 male-to-female transsexuals and 56 female-to-male transsexuals) to T scores obtained from a general psychiatric adult inpatient sample (n = 112) and T scores obtained from a normal adult sample (n = 112). The comparison groups were matched to the gender reassignment sample on the variables of biological gender and age. Rorschach data obtained from the gender reassignment sample were also compared to frequency data reported by Exner for normal, character disorder, and schizophrenic adults. Apart from a clinical range elevation on Scale 5, the gender reassignment candidates produced a normal range mean MMPI-2 profile. In contrast, the Rorschach findings suggested that reassignment candidates produce a high frequency of invalid protocols and manifest various psychological problems that are characteristic of individuals with personality disorders. These findings are discussed in terms of salient methodological and theoretical issues as well as promising directions for future research.

MMPI-Rorschach interrelationships: proposed criteria for evaluating explanatory models.

An extensive empirical literature, spanning 50 years and 45 published investigations, leads to the conclusion that the Rorschach and the Minnesota Multiphasic Personality Inventory (MMPI) bear little or no meaningful relationship to each other. An inherent tension exists between these empirical findings and the widespread clinical practice of integrating MMPI and Rorschach results. At least three perspectives have been advanced concerning the relationship between these two instruments. One view holds that variables from the two measures will demonstrate significant patterns of convergence only in carefully designed research studies that involve specific, well-constructed and theoretically derived predictions. A second view postulates that although variables from the Rorschach and MMPI do not bear a high intercorrelation with each other, these variables may be combined to contribute significantly to the prediction of outcome variance. In this view, the combined use of the two instruments yields clinically useful increases in incremental validity not achievable by the use of either instrument in isolation. A third approach is reflected in the proposition that although the MMPI and Rorschach do not produce significant interrelationships under general conditions, meaningful relationships may be yielded under specific psychometric conditions, for example, under conditions in which the response styles are consistently displayed across those two instruments. This article will review research evidence related to each of these perspectives, with particular emphasis on the importance of clearly specifying the criteria to be applied in evaluating these models. The concepts of parsimony and heuristic value are proposed for these evaluation purposes.